Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1013965151

Unknown Individual is a healthcare provider. based in Augusta, Georgia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 050890 (TX). The NPI Number for Unknown Individual is 1013965151

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013965151
Phone
(800) 394-4445
Address
804 SCOTT NIXON MEMORIAL DR
Deactivation Date
14 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2546900900
Graduation Year
1999 (27 years ago)
PAC ID
4284615196
Group Practice PAC ID
1355606641
Professional Enrollment ID
I20040526001463
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States

    AUGUSTA, GA 309072464

    Phone: (800) 394-4445

    Type: Mailing

  • CHRISTUS Spohn Hospital Corpus Christi - Memorial, 2606, Hospital Boulevard, Corpus Christi, Nueces County, Texas, 78405, United States

    CORPUS CHRISTI, TX 784051818

    Phone: (757) 482-6732

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30907)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355606641View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)TX
Anesthesiology, Interventional Pain ManagementTX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)MS
Certified Registered Nurse Anesthetist (Crna)TX
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1013965151 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Augusta, Georgia as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

Similar Providers

TAMMY MAHROOS (CRNA)

Certified Registered Nurse Anesthetist
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States
NPI: 1235132093

CAROLYN MASTRONI (CRNA)

Certified Registered Nurse Anesthetist
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States
NPI: 1316940166

JANET SEGEN (CRNA)

Certified Registered Nurse Anesthetist
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States of America
NPI: 1083617831

RUTH C PERRY (CRNA)

Certified Registered Nurse Anesthetist
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States of America
NPI: 1003819871

MARCIA EVANS (CRNA)

Certified Registered Nurse Anesthetist
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States of America
NPI: 1841293602

KRISTIN M. GERAGHTY (CRNA)

Certified Registered Nurse Anesthetist
Inova Schar Heart and Vascular, 3300, Gallows Road, Falls Church, Fairfax County, Virginia, 22042, United States
NPI: 1043207780

JAMES P MANDERLE (MD)

Certified Registered Nurse Anesthetist
804, Scott Nixon Memorial Drive, Augusta, Richmond County, Georgia, 30907, United States
NPI: 1013905769

MRS. JOANNE DILACQUA (CRNA)

Certified Registered Nurse Anesthetist
Capital Health Medical Center - Hopewell, 1, Capital Way, Pennington, Mercer County, New Jersey, 08534, United States
NPI: 1366430514
Box Turtle Run, Augusta Acres, Greenville County, South Carolina, 29636, United States
NPI: 1730179920